University of Wisconsin-Milwaukee, Joseph J. Zilber School of Public Health, Milwaukee, WI, USA.
University of Wisconsin-Milwaukee, Joseph J. Zilber School of Public Health, Milwaukee, WI, USA.
Ann Epidemiol. 2022 Feb;66:56-64. doi: 10.1016/j.annepidem.2021.11.007. Epub 2021 Nov 15.
Given the persistence of racial health disparities, scholars have called for investigations into structural origins of health inequity and deeper engagement with theory. We systematically assessed uses of theory-including theory informed conceptualizations of race and ethnicity, social structure, and racial hierarchy-in epidemiology and other quantitative population health literature on racial health disparities.
We conducted a scoping review of systematically identified original research articles (n=650) that sought to explain racial health disparities; articles were published in 17 high-impact epidemiology, public health, and social science journals. Trained coders abstracted data from each article. We applied Public Health Critical Race Praxis and an iterative data-charting method to identify key themes.
Only 63 (9.7%) of 650 racial health disparities articles explicitly used theory. Among studies that engaged theory, one third (n=21/63) clearly conceptualized race and/or ethnicity, and a minority theorized social structure (n=19/63; 30%) and/or racial hierarchy as a structural relation (n=4/63; 6%).
There is a pressing need for racial health disparities researchers to unambiguously use theory to conceptualize race and ethnicity in social and historical contexts and explain relational aspects of racial hierarchy. These approaches can better elucidate and inform action on structural determinants of both racial inequity and racial health inequity.
鉴于种族健康差异的持续存在，学者们呼吁对健康不平等的结构性根源进行调查，并更深入地参与理论研究。我们系统地评估了理论在流行病学和其他关于种族健康差异的定量人口健康文献中的应用，包括理论指导下对种族和族裔、社会结构和种族等级制度的概念化。
我们对旨在解释种族健康差异的系统确定的原始研究文章（n=650）进行了范围综述；这些文章发表在 17 种高影响力的流行病学、公共卫生和社会科学期刊上。经过培训的编码员从每篇文章中提取数据。我们应用公共卫生关键种族实践和迭代数据图表方法来确定关键主题。
在 650 篇种族健康差异文章中，只有 63 篇（9.7%）明确使用了理论。在涉及理论的研究中，三分之一（n=21/63）明确概念化了种族和/或族裔，少数人理论化了社会结构（n=19/63；30%）和/或种族等级制度作为一种结构性关系（n=4/63；6%）。
种族健康差异研究人员迫切需要明确使用理论来概念化种族和族裔在社会和历史背景下的概念，并解释种族等级制度的关系方面。这些方法可以更好地阐明和告知对种族不平等和种族健康不平等的结构性决定因素的行动。
